Brian E. Sandoval, Psy.D. Primary Care Behavioral Health Manager Yakima Valley Farm Workers Clinic

Size: px
Start display at page:

Download "Brian E. Sandoval, Psy.D. Primary Care Behavioral Health Manager Yakima Valley Farm Workers Clinic"

Transcription

1 Clinical Integration of Behavioral Health in Washington State: The Development of Practice Standards for Primary Care Service Delivery Brian E. Sandoval, Psy.D. Primary Care Behavioral Health Manager Yakima Valley Farm Workers Clinic Behavioral Health Committee Member Dr. Robert J. Bree Collaborative

2 Objectives Understand the need for clinical definitions and standards Learn why primary care integration is important and how it impacts the continuum of care delivery Determine how minimum standards align with primary care and PCMH delivery Define integrated primary care, who can provide services, and what elements are necessary for integration Conceptualize how the integration elements align with HCA priorities and next steps

3 Brief History Senate Bill 6312, House Bill 2572 Full integration of funding and delivery for physical health, mental health, and chemical dependency services by 2020 Idea was to integrate funding with clinical integration to follow Clinics began taking an initiative at integrating physical, behavioral, and SUD services Without a universal clinical definition, there has been wide variability in the practice of integrated BH across the state

4 The Bree Robert J. Bree Collaborative Established in 2011 by WA state legislature, ESHB 1311 Provides a mechanism through which public and private health care stakeholders can work together to improve quality, health outcomes, and cost effectiveness of care Bree s Behavioral Health Committee Consolidation of national and local efforts Tasked with defining BH integration in primary care and developing minimum practice standards Scope of work is limited to primary care but should connect to BH system Recommendations to be sent to HCA for review and approval

5 Behavioral Health Care Continuum

6 Why Primary Care? Primary care is the "De Facto" US mental health system 50-70% of primary care visits include a psychosocial component 11% prevalence of depression, 19% prevalence of anxiety in PC visits Depression increases cost of chronic conditions by % Barriers in outpatient referrals 50% of patients referred for specialty mental health do not make it Many patients drop out after just a few sessions Primary Care integration impacts the BH system Poor access and management in primary care places burden on system Goal is to improve allocation of resources across the system Matching level of intervention with level of care = better outcomes

7 Evolution of Primary Care Services General Primary Care Treat All Comers, High Volume Brief, Episodic Care and Chronic Care Expedited Access (Same Day) Proactive and Reactive Treatment Strategies Front Line of Care Shared Records/EHR among PC Staff Advanced Primary Care Activities Registries/Tracking (for key conditions) Risk Stratification/Protocols Systematic Follow-up Onsite or Close Collaboration with Specialists Shared Care Plans in EHR Patient Centered Medical Home Effective Population Health Quadruple Aim Alternative Payment/ VBP

8 General Primary Care Comprehensive Integration Treat All Comers, High Volume Brief, Episodic Care Chronic Care Expedited Access (Same Day) Proactive and Reactive Treatment Strategies Front Line of Care Shared Records/EHR among PC Staff PCBH Treat All Comers High Volume Brief, Episodic Care Expedited Access (Same Day) Health Behavior Change BHC Advanced Primary Care Activities Screening/Tracking Collaboration with Psychiatry MH/Depression Treatment Risk Stratification/ Protocols Psychiatrist Registries/Tracking (for key conditions) Risk Stratification/Protocols Systematic Follow-up Onsite/Close Collaboration with Specialists Shared Care Plans in EHR Focus on specific population outcomes PCMH Effective Population Health Quadruple Aim Alternative Payment / VBP Registries/Tracking (for key conditions) Systematic Follow-up Condition-focused outcome goals Collaborative Care Strength of both models align with PCMH service delivery Care Coordinator

9 General Goals of Standards Achieve integration in primary care: Routineness with which care is delivered in daily practice Consistent practice and alignment across the state Focus on integration elements, not models Alignment with Primary Care service delivery BH Needs to match general primary care practice and PCMH practice Improve access and enhance quality WA state is 48 th in BH Access nationally Achievable, yet aspirational

10 Standards Development AHRQ Lexicon AIMS Washington s Clinical Standards and Definitions Oregon Standards SAMHSA

11 The What Integrated Primary Care means care provided to individuals of all ages, families, and their caregivers in a patient centered medical home by licensed primary care providers, behavioral health clinicians, and other care team members working together to address one or more of the following: mental illness, substance use disorders, health behaviors that contribute to chronic illness, life stressors and crises, developmental risks/conditions, stress-related physical symptoms, preventative care, and ineffective patterns of health care utilization.

12 The Who "Behavioral Health Clinician" means a licensed psychiatrist, a licensed psychologist, a licensed nurse practitioner or registered nurse with a specialty in psychiatric mental health, a licensed independent clinical social worker, a licensed mental health counselor, a licensed marriage and family therapist, a certified clinical social work associate, an intern or resident who is working under a state-approved supervisory contract in a clinical mental health field; or any other clinician whose authorized scope of practice includes mental health diagnosis and treatment.

13 Standards and Concepts Integration Behavioral Health Clinician is an Integrated Team Member Accessibility and Sharing of Patient Information Access Access to Behavioral Health as Routine Part of Care Access to Psychiatry Services Quality Operational Systems and Workflows to Support Population Care Evidence-Based Treatments Data for Quality Improvement

14 Minimum Standards for Primary Care Integration Element 1: Behavioral Health Clinician is an Integrated Team Member Primary care team has clearly defined roles including for the behavioral health clinician. The behavioral health clinician participates in regular practice activities in-person or virtually such as team meetings, daily huddles, pre-visit planning, and quality improvement. Rationale: A practice cannot be integrated unless the BH clinician is a routine part of primary care delivery and quality measurement

15 Minimum Standards for Primary Care Integration Element 2: Access to Psychiatry Services Practice has access to psychiatry services including diagnostic clarification, medication management, care plan development through referral or consultation which includes shared bi-directional communication. Rationale: Access to psychiatry services is necessary to meet complex patient needs Psychiatry care without information sharing is not beneficial for population care

16 Minimum Standards for Primary Care Integration Element 3: Access to Behavioral Health as a Routine Part of Care Access to behavioral health services are available the same day as part of routine care in the primary care setting (either in person or virtually) to address identified behavioral needs. Follow-up appointments are also available in a timely manner to adequately address each patient s unique concern(s). Rationale: Same day access is necessary for engagement in behavioral care Motivation and follow-through on behavioral care is much worse when delivered on alternative days Same day access facilitates more coordinated care planning Ability for expedited follow-up decreases attrition and allows for f/u assessment

17 Minimum Standards for Primary Care Integration Element 4: Operational Systems and Workflows to Support Population Care A universal screening method is in place for identification and stratification of patients. The practice uses systematic clinical protocols that are followed based on screening results and patient severity. Clinic tracks identified patients to make sure patient is engaged and treated-to-target/remission and proactively follows-up and adapts treatment for patients who do not show improvement (for selected populations and measures). Rationale: Universal screening for mental health concerns is necessary for population management Universal screening without intervention is not beneficial, so clinical protocols are needed to actually improve population outcomes Tracking of patients necessary to provide stepped-care and quality reporting

18 Minimum Standards for Primary Care Integration Element 5: Accessibility and Sharing of Patient Information Medical and behavioral providers have a shared care plan accessible to all members of the integrated care team documented through a shared EHR and/or care management system and work together via regular consultation and coordination Rationale: Shared access to records is necessary to coordinate physical and behavioral care effectively Shared care planning is essential for integrated whole person care

19 Minimum Standards for Primary Care Integration Element 6: Evidence-Based Treatments Interventions are supported by evidence, best practices, and adaptable to a primary care setting. The goal of treatment is to provide strategies that include the patient s goals of care and appropriate self-management support. Rationale: Interventions not based on evidence or not amenable to primary care setting are less likely to produce valid outcomes Self-Management focus is consistent with primary care practice Innovation is key to enhancing the health system

20 Minimum Standards for Primary Care Integration Element 7: Data for Quality Improvement System-level data regarding access to behavioral care and patient outcomes is tracked. If system goals are not met, quality improvement efforts are employed to achieve patient access goals and outcome standards. Rationale: Quality improvement essential to sustainability and growth System-level data necessary for MCOs and pay-for-performance initiatives

21 Next Steps Technical Specifications finalized in early 2017 Minimum standards document sent out for public comment Final recommendations sent to HCA HCA approves or requests revision Distributed to stakeholders, purchasers, ACH, and others Short-term and long-term financial incentives developed

22 Questions?

Specialty Behavioral Health and Integrated Services

Specialty Behavioral Health and Integrated Services Introduction Behavioral health services that are provided within primary care clinics are important to meeting our members needs. Health Share of Oregon supports the integration of behavioral health and

More information

Central Oregon Integrated Care Collaborative: Operational Strategies for Success

Central Oregon Integrated Care Collaborative: Operational Strategies for Success Central Oregon Integrated Care Collaborative: Operational Strategies for Success 1 May 8, 2018 2 Welcome! Mike Franz, MD, DFAACAP, FAPA Medical Director, Behavioral Health, PacificSource Thanks to the

More information

Blending Behavioral Health and Primary Care. Cherokee Health Systems Clinical Model

Blending Behavioral Health and Primary Care. Cherokee Health Systems Clinical Model Blending Behavioral Health and Primary Care Cherokee Health Systems Clinical Model Brittany Tenbarge, Ph.D. Behavioral Health Consultant Licensed Clinical Psychologist Our Mission To improve the quality

More information

PROPOSED AMENDMENTS TO HOUSE BILL 4018

PROPOSED AMENDMENTS TO HOUSE BILL 4018 HB 01-1 (LC ) //1 (LHF/ps) Requested by Representative BUEHLER PROPOSED AMENDMENTS TO HOUSE BILL 01 1 1 1 1 On page 1 of the printed bill, line, after ORS insert.0 and. In line, delete Section and insert

More information

The Integration of Behavioral Health and Primary Care: A Leadership Perspective

The Integration of Behavioral Health and Primary Care: A Leadership Perspective The Integration of Behavioral Health and Primary Care: A Leadership Perspective Eboni Winford, Ph.D. Behavioral Health Consultant Cherokee Health Systems Our Mission To improve the quality of life for

More information

Integration Workgroup: Bi-Directional Integration Behavioral Health Settings

Integration Workgroup: Bi-Directional Integration Behavioral Health Settings The Accountable Community for Health of King County Integration Workgroup: Bi-Directional Integration Behavioral Health Settings May 7, 2018 1 Integrated Whole Person Care in Community Behavioral Health

More information

MEDICAID TRANSFORMATION PROJECT TOOLKIT

MEDICAID TRANSFORMATION PROJECT TOOLKIT MEDICAID TRANSFORMATION PROJECT TOOLKIT Medicaid Transformation Demonstration Contents Domain 1: Health and Community Systems Capacity Building... 2 Financial Sustainability through Value based Payment...

More information

Objectives. Models of Integrated Behavioral Health Care 9/23/2015

Objectives. Models of Integrated Behavioral Health Care 9/23/2015 Models of Integrated Behavioral Health Care Carlton D. Craig, Ph.D. Vernon R. Wiehe Endowed Professor in Family Violence University of Kentucky College of Social Work Carlton.craig@uky.edu (859)-257-6657

More information

Integrated Behavioral Health Services Austin Travis County Integral Care & CommUnityCare

Integrated Behavioral Health Services Austin Travis County Integral Care & CommUnityCare Integrated Behavioral Health Services Austin Travis County Integral Care & CommUnityCare Jim VanNorman, MD, Medical Director, ATCIC David Vander Straten, MD, FAAFP, CommUnityCare Discussion Review the

More information

Integrating Behavioral Health into the Primary Care Visit for Co-Morbid Disease. Kari B. Kirian, Ph.D.

Integrating Behavioral Health into the Primary Care Visit for Co-Morbid Disease. Kari B. Kirian, Ph.D. Integrating Behavioral Health into the Primary Care Visit for Co-Morbid Disease Kari B. Kirian, Ph.D. Objectives Integrated Care 101 Primary Care Behavioral Health (PCBH) PCBH at ECU Family Medicine Defining,

More information

Charting New Territory: Integrating Behavioral Health in Rural Group Practice

Charting New Territory: Integrating Behavioral Health in Rural Group Practice Charting New Territory: Integrating Behavioral Health in Rural Group Practice Shay Stacer, PhD Behavioral Health Consultant Licensed Clinical Psychologist Brief Training Bio Clinical Psychology PhD University

More information

Creating the Collaborative Care Team

Creating the Collaborative Care Team Creating the Collaborative Care Team Social Innovation Fund July 10, 2013 Social Innovation Fund Corporation for National & Community Service Federal Funder The John A. Hartford Foundation Philanthropic

More information

WPCC Workgroup. 2/20/2018 Meeting

WPCC Workgroup. 2/20/2018 Meeting WPCC Workgroup 2/20/2018 Meeting Today s Agenda 1. Introductions 2. Medicaid Transformation Overview 3. WPCC in the Transformation 4. Change Plan Overview 5. Review of Supporting Data 6. Change Plan Deep

More information

Instructions for Completing the BHICCI Case Rate Readiness Assessment (CRRA) and Workplan

Instructions for Completing the BHICCI Case Rate Readiness Assessment (CRRA) and Workplan Instructions for Completing the BHICCI Case Rate Readiness Assessment (CRRA) and Workplan IEHP intends to sustain integrated complex care through case rate funding to health care organizations/clinics

More information

CPC+ CHANGE PACKAGE January 2017

CPC+ CHANGE PACKAGE January 2017 CPC+ CHANGE PACKAGE January 2017 Table of Contents CPC+ DRIVER DIAGRAM... 3 CPC+ CHANGE PACKAGE... 4 DRIVER 1: Five Comprehensive Primary Care Functions... 4 FUNCTION 1: Access and Continuity... 4 FUNCTION

More information

Major Dimensions of Managed Behavioral Health Care Arrangements Level 3: MCO/BHO and Provider Contract

Major Dimensions of Managed Behavioral Health Care Arrangements Level 3: MCO/BHO and Provider Contract Introduction To understand how managed care operates in a state or locality it may be necessary to collect organizational, financial and clinical management information at multiple levels. For instance,

More information

A. PCMH Service Site: 1. Co-locate behavioral health services at primary care practice sites. All participating primary

A. PCMH Service Site: 1. Co-locate behavioral health services at primary care practice sites. All participating primary Domain 3 Projects 3.a.i Integration of Primary Care and Behavioral Health Services Project Objective: Integration of mental health and substance abuse with primary care services to ensure coordination

More information

PCMH Recognition Redesign: Annual Reporting Requirements to Sustain Recognition Overview & Table Reporting Period: 4/1/2017 3/31/2018

PCMH Recognition Redesign: Annual Reporting Requirements to Sustain Recognition Overview & Table Reporting Period: 4/1/2017 3/31/2018 PCMH Recognition Redesign: Annual Reporting to Sustain Recognition Overview & Table Reporting Period: 4/1/2017 3/31/2018 Redesign Goals NCQA is redesigning our PCMH Recognition program. The redesigned

More information

INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH

INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH INTEGRATION OF PRIMARY CARE AND BEHAVIORAL HEALTH Integrating silos of care Goal of integration: no wrong door to quality health care Moving From Moving Toward Primary Care Mental Health Services Substance

More information

Request for Proposal. Promoting Integrated Behavioral Health and Primary Care in New Hampshire

Request for Proposal. Promoting Integrated Behavioral Health and Primary Care in New Hampshire One Pillsbury Street, Suite 301 Concord, New Hampshire 03301 603-228-2448 KFirth@endowmentforhealth.org Purpose: 1 P a g e Request for Proposal Promoting Integrated Behavioral Health and Primary Care in

More information

Appendix 4. PCMH Distinction in Behavioral Health Integration

Appendix 4. PCMH Distinction in Behavioral Health Integration Appendix 4 PCMH Distinction in Behavioral Health Integration Appendix 4 PCMH Distinction in 4-1 Distinction Purpose and Background Behavioral health conditions (mental illnesses and substance use disorders)

More information

OUTPATIENT SERVICES. Components of Service

OUTPATIENT SERVICES. Components of Service OUTPATIENT SERVICES Providers contracted for this level of care or service are expected to comply with all requirements of these service-specific performance specifications. Additionally, providers contracted

More information

Annual Reporting Requirements for PCMH Recognition Overview & Table Reporting Period: 4/3/2017 3/31/2018

Annual Reporting Requirements for PCMH Recognition Overview & Table Reporting Period: 4/3/2017 3/31/2018 Annual Reporting Requirements for PCMH Recognition Overview & Table Reporting Period: 4/3/2017 3/31/2018 Redesign Goals NCQA is redesigning our PCMH Recognition program. The redesigned program to be launched

More information

Alternative or in Lieu of Service Description Alliance Behavioral Healthcare

Alternative or in Lieu of Service Description Alliance Behavioral Healthcare Alternative or in Lieu of Service Description Alliance Behavioral Healthcare 1. Service Name and Description: Rapid Response Crisis Services for Children and Youth Service Name: Rapid Response Procedure

More information

2

2 2 3 4 5 Keep moving SUCCESS REQUIRES CONTINUOUS DISRUPTION 6 7 10 11 12 13 15 Define or be defined What is integrated behavioral health and primary care? The care that results from a practice team

More information

The Long and Winding Road-map: From Waiver Services to VBP and Other Stops Along the Way

The Long and Winding Road-map: From Waiver Services to VBP and Other Stops Along the Way The Long and Winding Road-map: From Waiver Services to VBP and Other Stops Along the Way Mental Health Association in New York State, Inc. Annual Meeting Gregory Allen, MSW Director Division of Program

More information

Improvement Activities for ACI Bonus Measures

Improvement Activities for ACI Bonus Measures Improvement Activity Performance Category Subcategory Expanded Practice Activity Name Activity Improvement Activity Performance Category Weight Provide 24/7 access to eligible clinicians or groups, who

More information

Healthcare Transformation at. Cherokee Health Systems

Healthcare Transformation at. Cherokee Health Systems Dennis S. Freeman Chief Executive Officer Cherokee Health Systems Healthcare Transformation at Cherokee Health Systems Blending Behavioral Health Providers into the Patient-Centered Medical Home Speaker

More information

Strategies for Addressing Workforce Issues through Partnerships and Policy: An FQHC-University Partnership. Columbus, Ohio.

Strategies for Addressing Workforce Issues through Partnerships and Policy: An FQHC-University Partnership. Columbus, Ohio. College of Social Work Strategies for Addressing Workforce Issues through Partnerships and Policy: An FQHC-University Partnership Staci Swenson, MA, MSW, LISW S Integrated Care Manager PrimaryOne Health

More information

9/13/2017. Integrated Behavioral Health (IBH) MHCF Focus Areas. A little about myself

9/13/2017. Integrated Behavioral Health (IBH) MHCF Focus Areas. A little about myself Integrated Behavioral Health (IBH) 2017 www.mthcf.org Scott.Malloy@mthcf.org (406)451 7060 MHCF Focus Areas Three focus areas: 1. Behavioral Health o Integrated behavioral health initiative o Strengthening

More information

Integrated Behavioral Health Services

Integrated Behavioral Health Services Integrated Behavioral Health Services Anitra Walker, LCSW Liz Frye, MD, MPH Integrated Behavioral Health Background SHLI Integrated Care Initiative started in July 2011 2 initial demonstration sites; Focus

More information

Annual Reporting Requirements for PCMH Recognition Overview & Table Reporting Period: 4/3/ /31/2018

Annual Reporting Requirements for PCMH Recognition Overview & Table Reporting Period: 4/3/ /31/2018 Annual Reporting s for PCMH Recognition Overview & Table Reporting Period: 4/3/2017 12/31/2018 Redesign Goals NCQA redesigned its PCMH Recognition program in April 2017 for practices to maintain an ongoing

More information

MHANYS Behavioral Health Managed Care Update

MHANYS Behavioral Health Managed Care Update MHANYS Behavioral Health Managed Care Update Mental Health Association in New York State, Inc. October 28, 2016 September 22, 2016 2 Presentation Overview What are the Goals for the Medicaid Changes? Changes

More information

RPC and OMH Collaborative Care Webinar. February 1, pm

RPC and OMH Collaborative Care Webinar. February 1, pm RPC and OMH Collaborative Care Webinar February 1, 2018 1 2pm AGENDA Welcome & Introductions OMH Care Collaborative Overview Q&A Cathy Hoehn, LMHC RPC Initiative Director CH@clmhd.org 518 396 0788 www.clmhd.org/rpc

More information

Ryan White Part A. Quality Management

Ryan White Part A. Quality Management Quality Management Mental Health Services Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) The creation of this public document is fully funded by a federal Ryan White CARE Act Part A grant

More information

Relationships: The Behavioral Health Consultant, Primary Care Physician, and Psychiatrist i t Healthcare Integration Webinar National Council for Community Behavioral Healthcare February 25, 2010 The Status

More information

Ryan White Part A Quality Management

Ryan White Part A Quality Management Quality Management Mental Health Services Broward County/Fort Lauderdale Eligible Metropolitan Area (EMA) The creation of this public document is fully funded by a federal Ryan White CARE Act Part A grant

More information

Pediatric Behavioral Health: How to Improve Primary Care Coordination and Increase Access

Pediatric Behavioral Health: How to Improve Primary Care Coordination and Increase Access Population Health Advisor Pediatric Behavioral Health: How to Improve Primary Care Coordination and Increase Access Jasmaine McClain, PhD Senior Analyst, Research McClainJ@advisory.com 6 Introducing Population

More information

Using the BHI model in the Health Care for the Homeless Clinic utilizing a Team Approach

Using the BHI model in the Health Care for the Homeless Clinic utilizing a Team Approach Using the BHI model in the Health Care for the Homeless Clinic utilizing a Team Approach Lincoln Community Health Center Health Care for the Homeless Clinic 412 Liberty Street Durham NC, 27701 2015 National

More information

TRAINING THE INTEGRATED PRIMARY CARE PROFESSIONAL

TRAINING THE INTEGRATED PRIMARY CARE PROFESSIONAL TRAINING THE INTEGRATED PRIMARY CARE PROFESSIONAL STACY OGBEIDE, PSYD, MS ASSISTANT PROFESSOR/CLINICAL DEPARTMENT OF FAMILY & COMMUNITY MEDICINE DEPARTMENT OF PSYCHIATRY UT HEALTH SAN ANTONIO OBJECTIVES

More information

Provider Orientation to Magellan s Outpatient Behavioral Health Model

Provider Orientation to Magellan s Outpatient Behavioral Health Model Provider Orientation to Magellan s Outpatient Behavioral Health Model July 2017 Big-picture objectives Magellan Healthcare s outpatient care management model: Reduces provider administrative tasks Expedites

More information

Collaborative Care (IMPACT)- An Overview June 11, 2015

Collaborative Care (IMPACT)- An Overview June 11, 2015 Collaborative Care (IMPACT)- An Overview June 11, 2015 1 2 Mental Health in the US Depression is the leading cause of disability worldwide ~7% of US adults experienced major depression at least once during

More information

INTEGRATION AND COORDINATION OF BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE

INTEGRATION AND COORDINATION OF BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE THE CENTER FOR POLICY, ADVOCACY, AND EDUCATION OF THE MENTAL HEALTH ASSOCIATION OF NEW YORK CITY INTEGRATION AND COORDINATION OF BEHAVIORAL HEALTH SERVICES IN PRIMARY CARE A Presentation at The Community

More information

IMPLEMENTATION OF INTEGRATED CARE FROM A LEADERSHIP PERSPECTIVE. Tennessee Primary Care Association Annual Conference October 25 26, 2012.

IMPLEMENTATION OF INTEGRATED CARE FROM A LEADERSHIP PERSPECTIVE. Tennessee Primary Care Association Annual Conference October 25 26, 2012. IMPLEMENTATION OF INTEGRATED CARE FROM A LEADERSHIP PERSPECTIVE Tennessee Primary Care Association Annual Conference October 25 26, 2012 Outline I. Brief Overview of Cherokee (Who are we?) II. The Integrated

More information

Promoting Interoperability Performance Category Fact Sheet

Promoting Interoperability Performance Category Fact Sheet Promoting Interoperability Fact Sheet Health Services Advisory Group (HSAG) provides this eight-page fact sheet to help providers with understanding Activities that are eligible for the Promoting Interoperability

More information

Care Transitions Engaging Psychiatric Inpatients in Outpatient Care

Care Transitions Engaging Psychiatric Inpatients in Outpatient Care Care Transitions Engaging Psychiatric Inpatients in Outpatient Care Mark Olfson, MD, MPH Columbia University New York State Psychiatric Institute New York, NY A physician is obligated to consider more

More information

Healthcare Transformations in Primary Care Behavioral Health

Healthcare Transformations in Primary Care Behavioral Health Healthcare Transformations in Primary Care Behavioral Health Disclaimer The views expressed in this presentation are solely those of the author and do not reflect the official policy or position of the

More information

Using population health management tools to improve quality

Using population health management tools to improve quality Using population health management tools to improve quality Jessica Diamond, MPA, CPHQ Chief Population Health Officer CHCANYS Statewide Conference and Clinical Forum Sunday, October 18, 2015 Introduction

More information

Opportunities and Issues Related to BH Services in Primary Care

Opportunities and Issues Related to BH Services in Primary Care Opportunities and Issues Related to BH Services in Primary Care Roger Kathol, MD, CPE President, Cartesian Solutions, Inc. Adjunct Professor, Internal Medicine & Psychiatry, University of Minnesota Clinical

More information

QI ROUNDTABLE. NCQA PCMH 2017 Understanding the New Standards and Re-designed Recognition Process TUESDAY, NOVEMBER 7, 2017 YAKIMA, WA

QI ROUNDTABLE. NCQA PCMH 2017 Understanding the New Standards and Re-designed Recognition Process TUESDAY, NOVEMBER 7, 2017 YAKIMA, WA QI ROUNDTABLE NCQA PCMH 2017 Understanding the New Standards and Re-designed Recognition Process TUESDAY, NOVEMBER 7, 2017 YAKIMA, WA WELCOME HOUSEKEEPING Please sign in Folders Restrooms Electronic devices

More information

Executive Summary. BHICCI Charter

Executive Summary. BHICCI Charter Charter Behavioral Health Integration Complex Care Initiative Charter Clinical Transformation and Integration Department, Inland Empire Health Plan 1 Executive Summary The health care system serving the

More information

DOMAIN/STEP 8: OFFER INTEGRATED, COMPLEX CARE MANAGEMENT Activities

DOMAIN/STEP 8: OFFER INTEGRATED, COMPLEX CARE MANAGEMENT Activities Phase II: Develop Integrated Complex Care Systems (Whole Health Homes) DOMAIN/STEP 8: OFFER INTEGRATED, COMPLEX CARE MANAGEMENT July - Oct 2016 Oct 2016 - Feb 2017 Feb - July 2017 Develop Complex Care

More information

Behavioral Health Division JPS Health Network

Behavioral Health Division JPS Health Network Behavioral Health Division JPS Health Network Macro Trends 1 in 5 Adults in America experience a mental illness Diversion of Behavioral Health patients from jail Federal Prisons Mental Illness State Prison

More information

Macomb County Community Mental Health Level of Care Training Manual

Macomb County Community Mental Health Level of Care Training Manual 1 Macomb County Community Mental Health Level of Care Training Manual Introduction Services to Medicaid recipients are based on medical necessity for the service and not specific diagnoses. Services may

More information

Managed Medi-Cal Behavioral Health Benefits. Alliance Board Meeting October 23, 2013

Managed Medi-Cal Behavioral Health Benefits. Alliance Board Meeting October 23, 2013 Managed Medi-Cal Behavioral Health Benefits Alliance Board Meeting October 23, 2013 Purpose Discuss role of ACA in expanding benefits Review philosophy of integrated health care Review State policy process

More information

Reduce Readmissions & Avoidable ED Visits: Advocate Health Care s Medically Integrated Crisis Community Support

Reduce Readmissions & Avoidable ED Visits: Advocate Health Care s Medically Integrated Crisis Community Support Reduce Readmissions & Avoidable ED Visits: Advocate Health Care s Medically Integrated Crisis Community Support by Sheri Richardt, L.C.S.W. Manager for Crisis/CL/First Access/MICCS/After Care and Shastri

More information

Signature Leadership Series. Integrating Behavioral Health Across the Continuum of Care

Signature Leadership Series. Integrating Behavioral Health Across the Continuum of Care Signature Leadership Series Integrating Behavioral Health Across the Continuum of Care February 2014 Resources: For information related to behavioral and mental health, visit www.hpoe.org and http://www.aha.org/psych.

More information

Tips for PCMH Application Submission

Tips for PCMH Application Submission Tips for PCMH Application Submission Remain calm. The certification process is not as complicated as it looks. You will probably find you are already doing many of the required processes, and these are

More information

Santa Clara County, California Medicare- Medicaid Plan (MMP)

Santa Clara County, California Medicare- Medicaid Plan (MMP) Santa Clara County, California Medicare- Medicaid Plan (MMP) Behavioral health overview topics Topics covered: o Behavioral health (BH) covered services overview o BH noncovered services o Early and Periodic

More information

Financing and Sustainability Strategies for Behavioral Health Integration Anna Ratzliff, MD, PhD Associate Director for Education AIMS Center

Financing and Sustainability Strategies for Behavioral Health Integration Anna Ratzliff, MD, PhD Associate Director for Education AIMS Center Financing and Sustainability Strategies for Behavioral Health Integration Anna Ratzliff, MD, PhD Associate Director for Education AIMS Center Advancing Integrated Mental Health Solutions The Healthier

More information

REPORTING METRICS FOR INTEGRATION OF PHYSICAL-BEHAVIORAL HEALTH CARE

REPORTING METRICS FOR INTEGRATION OF PHYSICAL-BEHAVIORAL HEALTH CARE 9/26/213 REPORTING METRICS FOR INTEGRATION OF PHYSICAL-BEHAVIORAL HEALTH CARE MARISA DERMAN, MD, MSC (OMH) M. ASHLEY HEALD, MA (UW) OBJECTIVES FOR THIS WEBINAR Review goals/ standards Review mandatory

More information

NETWORK180 PROVIDER MANUAL SECTION 1: SERVICE REQUIREMENTS TARGETED CASE MANAGEMENT

NETWORK180 PROVIDER MANUAL SECTION 1: SERVICE REQUIREMENTS TARGETED CASE MANAGEMENT NETWORK180 PROVIDER MANUAL SECTION 1: SERVICE REQUIREMENTS TARGETED CASE MANAGEMENT Provider will comply with regulations and requirements as outlined in the Michigan Medicaid Provider Manual, Behavioral

More information

Readmission Prevention Programs. Vice President, Strategy & Development June 6, 2017

Readmission Prevention Programs. Vice President, Strategy & Development June 6, 2017 Readmission Prevention Programs Paul M. Duck @paulduck Vice President, Strategy & Development June 6, 2017 About Beacon Health Options Headquartered in Boston; more than 70 locations in the US and UK 5,000

More information

NCQA PCMH 2017 Standard Two 4/11/18. 6 PCMH Concepts within the standards

NCQA PCMH 2017 Standard Two 4/11/18. 6 PCMH Concepts within the standards Candace Chitty RN, MBA, CPHQ, PCMH-CCE 1 6 PCMH Concepts within the standards 1. Team-Based Care and Practice Organization (TC). 2. Knowing and Managing Your Patients (KM). 3. Patient-Centered Access and

More information

Primary Care/Behavioral Health Integration (3ai)

Primary Care/Behavioral Health Integration (3ai) Primary Care/Behavioral Health Integration (3ai) Standards of Care Summary Opportunity for PIC Input Standards of Care - Workgroup Workgroup Charge It is expected that standards of care be developed around

More information

Blending Behavioral Health and Primary Care. Applying the Model. Brittany Tenbarge, Ph.D. Behavioral Health Consultant Licensed Clinical Psychologist

Blending Behavioral Health and Primary Care. Applying the Model. Brittany Tenbarge, Ph.D. Behavioral Health Consultant Licensed Clinical Psychologist Blending Behavioral Health and Primary Care Applying the Model Brittany Tenbarge, Ph.D. Behavioral Health Consultant Licensed Clinical Psychologist Overview Introducing the Model to Patients Key Components

More information

Maine s Co- occurring Capability Self Assessment 1

Maine s Co- occurring Capability Self Assessment 1 Maine s Co- occurring Capability Self Assessment August 2009 Version 3.3 Date: Rater(s): Time Spent: Agency Name: Program Name: Program Type(s): Level of Care: Address: Contact Person: Title: Telephone:

More information

Patient-Centered Connected Care 2015 Recognition Program Overview. All materials 2016, National Committee for Quality Assurance

Patient-Centered Connected Care 2015 Recognition Program Overview. All materials 2016, National Committee for Quality Assurance Patient-Centered Connected Care 2015 Recognition Program Overview All materials 2016, National Committee for Quality Assurance Learning Objectives Introduction to Patient-Centered Connected Care and Eligibility

More information

SPOKANE COUNTY COMMUNITY SERVICES, HOUSING, AND COMMUNITY DEVELOPMENT DEPARTMENT (CSHCD)

SPOKANE COUNTY COMMUNITY SERVICES, HOUSING, AND COMMUNITY DEVELOPMENT DEPARTMENT (CSHCD) SPOKANE COUNTY COMMUNITY SERVICES, HOUSING, AND COMMUNITY DEVELOPMENT DEPARTMENT (CSHCD) Spokane County Community Services, Housing, and Community Development Department Spokane County Regional Behavioral

More information

Advancing Care Information Performance Category Fact Sheet

Advancing Care Information Performance Category Fact Sheet Fact Sheet The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) replaced three quality programs (the Medicare Electronic Health Record (EHR) Incentive program, the Physician Quality Reporting

More information

Standards of Practice for Professional Ambulatory Care Nursing... 17

Standards of Practice for Professional Ambulatory Care Nursing... 17 Table of Contents Scope and Standards Revision Team..................................................... 2 Introduction......................................................................... 5 Overview

More information

Transition Period. Parallel Paths to Purchasing Transformation 2020: RSAs. Fully Integrated Managed Care System

Transition Period. Parallel Paths to Purchasing Transformation 2020: RSAs. Fully Integrated Managed Care System 2 Parallel Paths to Purchasing Transformation 2020: Fully Integrated Managed Care System Transition Period 2014 Legislative Action: SSB 6312 By January 1, 2020, the community behavioral health program

More information

Care Compact Guide Patient-Centered Specialty Care (PCSC) A Component of Medical Neighborhood Initiatives

Care Compact Guide Patient-Centered Specialty Care (PCSC) A Component of Medical Neighborhood Initiatives Compact Guide Patient-Centered Specialty (PCSC) A Component of Medical Neighborhood Initiatives Services provided by Empire HealthChoice HMO, Inc. and/or Empire HealthChoice Assurance, Inc., licensees

More information

Mental Health Atlas Department of Mental Health and Substance Abuse, World Health Organization. Mongolia

Mental Health Atlas Department of Mental Health and Substance Abuse, World Health Organization. Mongolia GENERAL INFORMATION Mongolia Mongolia is a country with an approximate area of 1567 thousand square kilometers (O, 2008). The population is 2,701,117 and the sex ratio (men per hundred women) is 98 (O,

More information

Widespread prescribing, distribution and availability of naloxone for high risk individuals and as rescue medication 2

Widespread prescribing, distribution and availability of naloxone for high risk individuals and as rescue medication 2 Co Occurring Collaborative Serving Maine Expanding Medication Assisted Recovery Services & Building a Stronger Recovery Oriented System for SUD Treatment in Maine April 2018 Introduction: With support

More information

From Reactive to Proactive: Creating a Population Management Platform

From Reactive to Proactive: Creating a Population Management Platform Session D9 / E9 From Reactive to Proactive: Creating a Population Management Platform Richard Gitomer, MD Director, Brigham and Women s Primary Care Center of Excellence Vice Chair, Primary Care, Dept.

More information

Integrated Behavioral Health

Integrated Behavioral Health 1, Core Competencies, Chapter 16 Integrated Behavioral Health Contributor: Michael Mabanglo and Elizabeth Morrison Edited by Marc Avery Revision Date: 2/6/17 Definition and Why Supporting Integrated Behavioral

More information

Primary Care Redesign: Perspective from the New York State Department of Health October 3, 2017

Primary Care Redesign: Perspective from the New York State Department of Health October 3, 2017 Primary Care Redesign: Perspective from the New York State Department of Health October 3, 2017 Marcus Friedrich, MD, MBA, FACP Chief Medical Officer Office of Quality and Patient Safety NYSDOH Marcus.Friedrich@Health.NY.Gov

More information

Welcome to the Webinar!

Welcome to the Webinar! Welcome to the Webinar! We will begin the presentation shortly. Thank you for your patience. Attendees can access the presentation slides now at: http://www.mctac.org/page/events A recording of the event

More information

Integrated Mental Health Care. Questions

Integrated Mental Health Care. Questions Integrated Mental Health Care Closing the gap between what we know and what we do. Jürgen Unützer, MD, MPH, MA Questions Due to the large number of participants, it is not practical to take questions over

More information

Value-Based Payment Model Designs for Behavioral Health Services in Primary Care

Value-Based Payment Model Designs for Behavioral Health Services in Primary Care Value-Based Payment Model Designs for Behavioral Health Services in Primary Care Using collaborative depression care management as a case study due to existing evidence, experience, and measures Robert

More information

Clinical Utilization Management Guideline

Clinical Utilization Management Guideline Clinical Utilization Management Guideline Subject: Therapeutic Behavioral On-Site Services for Recipients Under the Age of 21 Years Status: New Current Effective Date: January 2018 Description Last Review

More information

BHS Policies and Procedures

BHS Policies and Procedures BHS Policies and Procedures City and County of San Francisco Department of Public Health San Francisco Health Network BEHAVIORAL HEALTH SERVICES 1380 Howard Street, 5th Floor San Francisco, CA 94103 415.255-3400

More information

Division of Mental Health, Developmental Disabilities & Substance Abuse Services NC Mental Health and Substance Use Service Array Survey

Division of Mental Health, Developmental Disabilities & Substance Abuse Services NC Mental Health and Substance Use Service Array Survey Table 1 Service Name Include any subcategories of service on a separate line In Table 2, please add service description and key terms Outpatient Treatment Behavioral Health Urgent Care (a type of outpatient)

More information

Certified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers

Certified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers Certified Community Behavioral Health Centers and New York State s Healthcare Reform: Considerations for Providers November 30, 2015 Joshua Rubin HealthManagement.com Plan CCBHC basics NYS Health Reform

More information

Psychiatric care in Switzerland: recent evolutions and perspectives. P. Giannakopoulos

Psychiatric care in Switzerland: recent evolutions and perspectives. P. Giannakopoulos Psychiatric care in Switzerland: recent evolutions and perspectives P. Giannakopoulos Recent evolution of mental disorders in Switzerland: epidemiological aspects Mental health problems represent a major

More information

Paula Stone Deputy Director, DMS, DHS

Paula Stone Deputy Director, DMS, DHS Paula Stone Deputy Director, DMS, DHS 1 Outpatient mental health services available to AR Medicaid beneficiaries include: Individual, family and group counseling services provided in an outpatient agency

More information

11/18/2016. A Regional Medicaid Accountable Care Organization (ACO) that would leverage the existing behavioral health managed care foundation.

11/18/2016. A Regional Medicaid Accountable Care Organization (ACO) that would leverage the existing behavioral health managed care foundation. This collaborative effort gained momentum and resulted in the release of a white paper, which proposed a solution to the vision of the Governor and General Assembly for integrated care in a capitated environment.

More information

HCMC Outpatient Mental Health Programs. External Referral Form

HCMC Outpatient Mental Health Programs. External Referral Form HCMC Outpatient Mental Health Programs External Referral Form Thank you for your interest in the Day Treatment, Partial Hospital Program, or Dialectical Behavior Therapy Intensive Outpatient Program. All

More information

THE AFFORDABLE CARE ACT: OPPORTUNITIES FOR SOCIAL WORK PRACTICE IN INTEGRATED CARE SETTINGS. Suzanne Daub, LCSW April 22, 2014

THE AFFORDABLE CARE ACT: OPPORTUNITIES FOR SOCIAL WORK PRACTICE IN INTEGRATED CARE SETTINGS. Suzanne Daub, LCSW April 22, 2014 THE AFFORDABLE CARE ACT: OPPORTUNITIES FOR SOCIAL WORK PRACTICE IN INTEGRATED CARE SETTINGS Suzanne Daub, LCSW April 22, 2014 Agenda Why integrate primary care and behavioral health? Define integrated

More information

What I need to know if I am considering setting up a DBT Programme in my service

What I need to know if I am considering setting up a DBT Programme in my service What I need to know if I am considering setting up a DBT Programme in my service Produced by Daniel Flynn, Clinical Psychologist (Programme Leader), and Jemma Deegan, Research Assistant, The Endeavour

More information

Improving Mental Health Services in Schools

Improving Mental Health Services in Schools House Select Committee on School Safety Student Health Working Group Improving Mental Health Services in Schools Mark T. Benton Department of Health and Human Services April 9, 2018 Unrecognized and untreated,

More information

GROWING THE PRIMARY CARE BEHAVIORAL HEALTH WORKFORCE OF TOMORROW ALEXANDER BLOUNT, ED.D.

GROWING THE PRIMARY CARE BEHAVIORAL HEALTH WORKFORCE OF TOMORROW ALEXANDER BLOUNT, ED.D. GROWING THE PRIMARY CARE BEHAVIORAL HEALTH WORKFORCE OF TOMORROW ALEXANDER BLOUNT, ED.D. Disclosure: I will mention the training programs of the Center for Integrated Primary Care at the University of

More information

Care Coordination Overview. Janet Tennison, PhD UPV Standards October 8, 2013

Care Coordination Overview. Janet Tennison, PhD UPV Standards October 8, 2013 Care Coordination Overview Janet Tennison, PhD UPV Standards October 8, 2013 What IS Care Coordination? The deliberate, proactive organization of patient care activities between two or more participants

More information

CHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE

CHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE Human Services[441] Ch 24, p.1 CHAPTER 24 ACCREDITATION OF PROVIDERS OF SERVICES TO PERSONS WITH MENTAL ILLNESS, MENTAL RETARDATION, AND DEVELOPMENTAL DISABILITIES PREAMBLE The mental health, mental retardation,

More information

Behavioral Health Competencies in Primary Care

Behavioral Health Competencies in Primary Care Behavioral Health Competencies in Primary Care SIM Training for Practice Facilitators and Clinical HIT Advisors Shale Wong, MD, MSPH January 20, 2016 Establishing Core Competencies for Behavioral Health

More information

Integrating Behavioral Health Across Integrated Delivery Systems

Integrating Behavioral Health Across Integrated Delivery Systems Integrating Behavioral Health Across Integrated Delivery Systems Speaker Lori Raney, MD, Principal, Robin Henderson, PsyD, Chief Executive, Behavioral Health Providence Medical Group May 12, 2016 HealthManagement.com

More information

Mental / Behavioral Health Screening in Pediatric Primary Care OVERVIEW OF THE PEDIATRIC PSYCHIATRY COLLABORATIVE PROGRAM

Mental / Behavioral Health Screening in Pediatric Primary Care OVERVIEW OF THE PEDIATRIC PSYCHIATRY COLLABORATIVE PROGRAM Mental / Behavioral Health Screening in Pediatric Primary Care OVERVIEW OF THE PEDIATRIC PSYCHIATRY COLLABORATIVE PROGRAM 1 Co-Presenters Ray Hanbury, Ph.D., A.B.P.P. Chief Psychologist, Dept. of Psychiatry

More information

CMS Oncology Care Model s Standards for Patient Navigation

CMS Oncology Care Model s Standards for Patient Navigation CMS Oncology Care Model s Standards for Patient Navigation Nikolas Buescher Executive Director of Cancer Services Penn Medicine, Lancaster November 13, 2017 Ann B Barshinger Health Cancer Institute scale

More information

STAR+PLUS through UnitedHealthcare Community Plan

STAR+PLUS through UnitedHealthcare Community Plan STAR+PLUS through UnitedHealthcare Community Plan Optum 06012014 Who We Are United Behavioral Health (UBH) was created February 2, 1997, through a merger of U.S. Behavioral Health, Inc. (USBH) and United

More information